Last year, 321 Norwegian women gave birth involuntarily outside a place of birth. Many tried, but never succeeded. New figures from Statistics Norway (SSB) show that the driving time to the nearest place of birth in the country varies enormously. Not reaching the place of birth increases the risk of stillbirth for the infant. When the journey time is longer than one hour, the risk increases. At the same time, approximately 100,000 women have to drive longer than this. The biggest difference is between Træna and Volda. In Volda, it is only three minutes or less to the nearest place of birth for half of the women. On the archipelagos in Nordland, it is the exact opposite. Several women have a journey of over two hours to the nearest place of birth. Monica Nundal Hålien in Årdal is one of these. news has collected all the figures from the survey. Further down you can search for your municipality. Hålien lives in Offerdalen in Årdal. This summer she had her period for the first time. “My God, will I make it there?” When the contractions started, she and her partner set out on a 2 hour and 20 minute walk. First to Lærdal hospital by car. So on in the ambulance to the hospital where she could actually give birth. – When the contractions started, I thought “Oh my God, am I going to make it?” I think it was absolutely terrible to have to drive all the way from Lærdal hospital to Voss hospital, she says. In the belly, little Sanna was ready to face the world. – The trip by ambulance to Voss was quite hard. It was not pleasant to lie in the back of the ambulance with contractions every five minutes. It felt like a long trip, she says. Father Ivar Endreson Offerdal with Sanna in his arms at Voss hospital, where the family would like to emphasize that they felt well looked after by the midwives. Photo: Privat The risk increases with driving time Last year, 151 women gave birth during transport to the maternity ward. 170 women gave birth unplanned at home. Here you can search for the median driving time in your municipality. Municipalities with a journey time of over two hours have increased by 5 per cent from 2012 to 18 per cent. – It is problematic because Norwegian women experience transport births as both terrifying and dramatic, says Hanne Charlotte Schjelderup, head of the Swedish Femicide Association. Due to few ferry departures per day, the journey time is estimated at seven hours for residents of the island municipalities of Røst and Træna. – Potentially life-threatening complications increase in parallel with distance, but an hour’s distance is the limit for where we see significant risk for the birth, says Schjelderup. Head of the Midwives Association Hanne Charlotte Schjelderup. Photo: Norwegian Nurses’ Association – Increased risk of stillbirth Researchers at the University of Bergen have previously concluded that the distance to the maternity service has the greatest significance for birth safety in Norway. Hilde Marie Engjom, senior physician and researcher at the Institute of Public Health, has researched what long driving times mean. – Not reaching the planned place of birth increases the risk of stillbirth during childbirth and infant death within the first 24 hours, says Engjom. Hilde Engjom has seen a reduction in maternity services since the 1980s. Senior physician and researcher at the Norwegian Institute of Public Health. Photo: Julianne Bråten Mossing / news – In recent decades, the risk of giving birth unplanned outside an institution has increased both in the cities and in the countryside, she says. Anxiety and stress are more common for women with a long journey ahead of a birth, according to the doctor, who refers to research from abroad. She says research from Sweden shows that the risk of giving birth outside an institution increases already after 30 minutes, according to Engjom. – Quite sick – The development is that maternity wards are being closed in the summer, closed at weekends and cut across the country, says Marie Grødahl Brekkan, general manager of Bunadsgeriljaen. On Tuesday, she is in Oslo to demonstrate in front of the Storting. However, due to financial constraints at several of the health institutions, several maternity wards may be closed in the summer or for longer periods. – It is centralized everywhere, which means that more and more people have longer journeys. Those who sit and make these decisions do not take into account research that shows that increased risk comes with increased travel distance. It is quite sick, says Brekkan. Marie Grødahl Brekkan is a leader in the Bunadsgeriljaen. Photo: Marius André Jenssen Stenberg / news The Minister of Health: Most involuntary transport births in the cities Minister of Health and Care Ingvild Kjerkol (Ap) believes the government is working for a good delivery service throughout the country. “Lack of personnel is the biggest problem now, and it cannot be solved with increased funding alone,” she writes to news. – What is the government doing to ensure that more people have shorter driving times to the nearest maternity services? “It is important to have good on-call readiness and an escort service for pregnant women and those giving birth with a journey of more than 90 minutes. The number of involuntary births outside hospital has remained stable over the past 15 years. Most such births do not take place in the rural areas, but in cities and central areas where the women cannot reach the hospital even if the road is short,” Kjerkol replies. See all her answers here: The Minister of Health answers about maternity services in Norway What is the government doing to ensure that more people have a shorter driving time to the nearest maternity services? Answer: It is important for the government that we have good on-call readiness and an escort service for those who live far away from a hospital with a maternity ward. The health institutions must provide an accompanying service for pregnant women and those giving birth with a journey of more than 90 minutes. The number of involuntary births outside hospital has remained stable over the past 15 years. Most such births do not take place in rural areas, but in cities and central areas where the women cannot reach the hospital even if the journey is short. We want to reduce the number of transport births. With closer follow-up of women who are expecting a child, we can detect more pregnancies with complications and more pregnancies where there is a risk that the birth will happen quickly and unexpectedly. In what way is research taken into account (that long journey times lead to increased risk) when decisions to close maternity wards are made? Answer: It is the health organization that is responsible for ensuring good and sound birth and maternity care, in line with the Norwegian Directorate of Health’s professional recommendations. These recommendations are based on up-to-date knowledge. Merging maternity wards is considered in some places to be the most sensible thing to do in the summer in order to give all the employees a holiday. If not, some departments would have to be staffed almost exclusively by hired temporary workers in the summer. This is unfortunate because temporary workers do not know routines and local conditions and, moreover, in recent years it has been difficult to get hold of Norwegian, Swedish and Danish temporary workers. The Maternity Rebellion believes it has “been cut more, closed more” this year. What is the government doing to prevent maternity services being reduced in rural areas? Answer: The government is working for a good supply of food throughout the country. Lack of personnel is the biggest problem now, and it cannot be solved with increased funding alone. There is a great need for midwives, and at times the working situation can be challenging in maternity wards with 24/7 operation. Good maternity care depends on having enough midwives, both in municipalities and in maternity wards in hospitals. These are challenges that we will work actively to meet, including by educating more people. In order to improve access to midwives, we have increased the number of study places and educational positions within midwifery education. In what way does the government assess the funding model for the health institutions in relation to maternity care? Is it too unprofitable, and does it lead to declines? Answer: A lack of personnel is the biggest problem now, and it cannot be solved with adjustments to the funding arrangements alone. The funding model for the hospitals in Norway is based on a mix between framework funding and funding based on activity. In the state budget for 2023, we have proposed to reduce the share of effort-based funding with a corresponding increase in the share of framework funding. This will give the regional health organizations increased strategic room for action. It can make it financially easier for the hospitals to prioritize tasks that do not generate income through performance-based funding. Criticizes SSB Brekkan believes parts of the statistics are misleading, and reacts that the maternity ward in Kristiansund counts in the calculation. The maternity ward has been closed since February 2021, except for a few weeks this summer. – As in Smøla, Aure and the municipalities outside Kristiansund, you have to add 67 minutes to the time stated on SSB to get to Molde, says Grødahl. Statistics Norway has been presented with the criticism from Brekkan, and states that it is difficult to create a fixed population per year. Councilor Sindre Mikael Hauken states that the closure in Kristiansund undoubtedly leads to longer driving times.
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Check your municipality – the driving time to the nearest place of birth ranges from 3 minutes to 7 hours – news Vestland
